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Application

Start your journey with ICDM.

1

Personal Information

2

Additional Details

1

Cosec Personal Information

2

Business Details

3

Declaration, Undertaking, Authorisation

Application Type*

Individual

Corporate

Salutation*

Full Name as per IC or Passport No. (if foreigner)*

Preferred Name*

Identification*

Passport Expiry Date

Date of Birth*

Contact No.*

Nationality*

Place of Birth*

Email Address*

Confirm Email Address*

Password*

Confirm Password*

Password must be at least 8 characters, consisting of symbol, number & uppercase and lowercase letter.

How did you hear about ICDM Membership?*

Are you a Reciprocal Member?*

Yes

No

IoD Country*

IoD Membership Certificate*

Supported format: .pdf .png .jpg .jpeg

Maximum Size: 5MB

Membership Category* Membership Benefits

Corporate Membership Category*

Application Type*

1-Year Plan (standard)

2-Years Plan (standard)

3-Years Plan (15% saving)

5-Years Plan (20% saving)

Lifetime Limited (15 years)

Total Fee: RM 0.00

Application Type*

1-Year Plan (standard)

2-Years Plan (standard)

3-Years Plan (15% saving)

5-Years Plan (20% saving)

Lifetime Membership

Total Fee: RM 0.00

Upload CV*

Supported format: .pdf .doc .docx

Maximum Size: 2MB

Current/Past Working Experience

Company Name*

Type*

Industry*

• Sub Industry description will display here.

Designation*

Position*

Year Start*

Still current/ Present

Year End*

Board Experience

Board Experience #1

Company Name*

Type*

Industry*

• Sub Industry description will display here.

Board Company Website*

Designation*

I confirm that this private company met the RM3 mil annual revenue requirement.

Revenue Details / Write-up

Year Start*

Still current/ Present

Year End*

Board Role*

Total Board Experience: (Calculation based on provided dates)

0 years

Correspondence Address

street 1*

street 2

city*

Postcode*

Country*

Where are you currently working?*

Corporate Information

Organisation name*

Type of Organisation*

Business Registration No*

Company TIN No.*

Industry*

• Sub Industry description will display here.

I hereby declare and confirm that my entity is listed on the Ministry of Higher Education (MOHE) website as a Public University, or qualifies as a Small or Medium Enterprise (SME) in accordance with the applicable annual turnover thresholds:

Manufacturing sector:
Small enterprise: RM 300,000 to less than RM 15 million
Medium enterprise: RM 15 million to not exceeding RM 50 million

Services and other sectors:
Small enterprise: RM 300,000 to less than RM 3 million
Medium enterprise: RM 3 million to not exceeding RM 20 million

I acknowledge that ICDM reserves the right to adjust the membership category if any information provided is found to be inaccurate, incomplete, or inconsistent during the due diligence process.

Upload SSM Document*

Choose file

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Maximum Size: 5MB

Upload Relevant Documents

You can select more than 1 file to support your chosen category

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Maximum Size: 5MB per file

You can select multiple files

Corporate Address

Business Registered address*

City*

Postal Code*

State*

Country*

CEO Information

CEO Salutation*

CEO Name*

CEO Phone Number*

CEO Mobile Number*

CEO Email Address*

Declaration, Undertaking, Authorisation

The company hereby applies for membership of the ICDM and the company irrevocably agrees to be bound by the Rules of the ICDM and all rules and regulations made under it from time to time. The company has sought confirmation from the respective directors of the company and confirms that:

its directors has not been disqualified (by court order or voluntary undertaking) from being a director of any company, nor is the company aware of any circumstances which may lead to such disqualifications;
the directors of the company do not have any criminal convictions (other than compounds for traffic offences);
it does not have any directors who is an undischarged bankrupt nor is the company aware of any circumstances that may lead to bankruptcy proceedings being brought against any of its directors; and

The company hereby undertakes in itself and undertakes to ensure and procure each of its directors:

to comply with, where applicable, the Rules of ICDM, ICDM Members' By-Laws and all rules and regulations made by ICDM from time to time;
to conduct itself, both publicly and privately, in a professional manner and so as to uphold the ICDM's reputation as stipulated in ICDM Code of Conduct; and
not to represent publicly the views of the ICDM or to claim support, without the consent of the Board (or of an officer or employee of the ICDM nominated by the Board for such purpose).

The company hereby give consent:

to allow ICDM to feature the company name & company logo on the ICDM website and any other communication channels to indicate that the company is ICDM Corporate Member.

The company hereby warrants and undertakes to ICDM that:

it will procure its authorised representative to create an account in the ICDM+ Portal for and on behalf of the company and for each of its directors, and to update the provided information (eg. any changes in the composition of its board) within thirty (30) days from the effective date of such change, for the purposes set out under the ICDM Website & Portal Terms of Use;
it will ensure that the information uploaded onto ICDM+ Portal is current and accurate;
it will ensure and procure each of its directors to submit a copy of their most recent CV through the ICDM+ Portal within [thirty (30) days] from the submission of this application.
it will, where reasonably possible, ensure its directors are aware of and will comply with the applicable provisions set out under the ICDM Website & Portal Terms of Use;
the company has provided a copy of ICDM's Privacy Policy at www.icdm.com.my/privacy, as revised and updated, to its authorised representative and has procured the individual's (and directors, where applicable) consent to provide his/her personal data to ICDM for the purposes set out under ICDM's Privacy Policy; and
any changes to the ICDM Website & Portal Terms of Use and/or Privacy Policy, will reflected on the ICDM Website. Continued usage of the service will signify that the company agrees to, and request for its directors to agree to, any such changes.

I agree to the Consent & Declaration.

I agree to accept the Terms Of Use and Privacy Policy of ICDM.

Consent & Declaration

Consent & Declaration*

I hereby apply for membership of the ICDM and I irrevocably agree to be bound by ICDM By-Laws and all rules and regulations made by ICDM from time to time. I confirm that:

I am not disqualified (by court order or voluntary undertaking) from being a director of any company, nor am I aware of any circumstances which may lead to such disqualification.
I do not have any criminal convictions (other than compounds for traffic offences);
I am not an undischarged bankrupt nor am I aware of any circumstances that may lead to bankruptcy proceedings being brought against me; and

I hereby undertake:

to comply with the Rules of ICDM;
to conduct myself, both publicly and privately, in a professional manner and so as to uphold the ICDM’s reputation as stipulated in ICDM Code of Conduct; and
not to represent publicly the views of the ICDM or to claim its support, without the consent of the Board (or of an officer or employee of the ICDM nominated by the Board for such purpose); and

I hereby consent to ICDM:

To create an account in the ICDM Portal for me & update the provided information accordingly.
The use of my personal information and all information provided by me for the purposes set out under ICDM’s Privacy Policy as revised and updated.
Any changes to our terms of use or Privacy Policy, will be reflected on the website. Continued usage of the service will signify that you agree to any such changes.

I agree to pay the applicable amount along with my membership application.

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